Background:.Pancreatic fistula after distal pancreatectomy is a common and potentially lethal complication.The optimal closure method for the pancreatic remnant during minimally invasive distal pancreatectomy (MDP) remains unclear.Methods:.
Data of consecutive patients who underwent MDP in our institution between July 2018 and June 2021 were collected.The outcomes of MDP with stapler and hand-sewn closure were compared.The primary outcome was clinically relevant postoperative pancreatic fistula Hotpoint HUE61GS Ultima Free Standing A/A Electric Cooker with Ceramic Hob 60cm (CR-POPF) per the International Study Group of Pancreatic Surgery definition.Results:.
Of the 384 patients (stapler closure, 339; hand-sewn closure, 45) enrolled, 249 developed CR-POPF (grades B and C: 242 and 7 patients, respectively).The rates of grade B and grade C POPF in the stapler group were similar to the corresponding rates in the hand-sewn group (64.6% and 1.5% vs 51.
1% and 4.4%, P =.078 and P =.223, respectively).
No differences between the stapler and hand-sewn groups were observed regarding the median operation time (207 vs 222 minutes, P =.139), incidence of major complications (16.5% vs 20.0%, P =.
559), and mortality (0.2% vs 0%, P = 1.000).The independent risk factors of CR-POPF were abdominal abscess, prolonged operation time, and transection site (P =.
004,.006, and.001, respectively).Conclusion:.
The incidence and severity of CR-POPF by stapler closure of the pancreatic stump were comparable to those associated with hand-sewn closure in MDP Obsolete Parts With Alternative Or Secondhand Available in this retrospective cohort.Randomized controlled trials are needed to verify this finding.